Boerner, T. and Graichen, A. and Jeiter, T. and Zemann, F. and Renner, P. and Maerz, L. and Soeder, Y. and Schlitt, H. J. and Piso, P. and Dahlke, M. H. (2016) CRS-HIPEC Prolongs Survival but is Not Curative for Patients with Peritoneal Carcinomatosis of Gastric Cancer. ANNALS OF SURGICAL ONCOLOGY, 23 (12). pp. 3972-3977. ISSN 1068-9265, 1534-4681
Full text not available from this repository. (Request a copy)Abstract
Peritoneal carcinomatosis (PC) is a dismal feature of gastric cancer that most often is treated by systemic palliative chemotherapy. In this retrospective matched pairs-analysis, we sought to establish whether specific patient subgroups alternatively should be offered a multimodal therapy concept, including cytoreductive surgery (CRS) and intraoperative hyperthermic chemotherapy (HIPEC). Clinical outcomes of 38 consecutive patients treated with gastrectomy, CRS and HIPEC for advanced gastric cancer with PC were compared to patients treated by palliative management (with and without gastrectomy) and to patients with advanced gastric cancer with no evidence of PC. Kaplan-Meier survival curves and multivariate Cox regression models were applied. Median survival time after gastrectomy was similar between patients receiving CRS-HIPEC and matched control patients operated for advanced gastric cancer without PC [18.1 months, confidence interval (CI) 10.1-26.0 vs. 21.8 months, CI 8.0-35.5 months], resulting in comparable 5-year survival (11.9 vs. 12.1 %). The median survival time after first diagnosis of PC for gastric cancer was 17.2 months (CI 10.1-24.2 months) in the CRS-HIPEC group compared with 11.0 months (CI 7.4-14.6 months) for those treated by gastrectomy and chemotherapy alone, resulting in a twofold increase of 2-year survival (35.8 vs. 16.9 %). We provide retrospective evidence that multimodal treatment with gastrectomy, CRS, and HIPEC is associated with improved survival for patients with PC of advanced gastric cancer compared with gastrectomy and palliative chemotherapy alone. We also show that patients treated with CRS-HIPEC have comparable survival to matched control patients without PC. However, regardless of treatment scheme, all patients subsequently recur and die of disease.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | MULTICENTER PHASE-III; CLINICAL-PRACTICE GUIDELINES; CYTOREDUCTIVE SURGERY; INTRAPERITONEAL CHEMOHYPERTHERMIA; PERIOPERATIVE CHEMOTHERAPY; FOLLOW-UP; ADENOCARCINOMA; MANAGEMENT; DIAGNOSIS; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Chirurgie Medicine > Zentren des Universitätsklinikums Regensburg > Zentrum für Klinische Studien |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 24 Apr 2019 08:16 |
| Last Modified: | 24 Apr 2019 08:16 |
| URI: | https://pred.uni-regensburg.de/id/eprint/4071 |
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